“There is a time when the community as a whole, their needs are better than the individual and I think more important. And right now the individuals are trumping the general populace at large. I find it frankly offensive and amoral.” Dr. Nancy Snyderman
(That's a snap of Professor Delores Jane Umbridge from Harry Potter and the Order of the Phoenix. She tries to take over Hogwarts school, and ends up being carted off into the forest, still shrieking commands, by a gang of angry centaurs.)
By Becky Estepp
I woke up last Wednesday feeling great. Months ago I had purchased tickets for the Angels vs. Red Sox game for that afternoon. My younger (neuro-typical) son and I were looking forward to a day filled with blue skies, sunshine, stadium snacks and rooting for his favorite team, the Red Sox. More importantly, my son and I would have one of those rare days that did not revolve around autism.
Angel stadium is an hour-and-a-half drive from our house, so we’d need to leave quite early to make the noon game. As I got ready to go, I turned on the TV and caught the Today show for about five minutes. As the television warmed up I could hear Dr. Nancy Snyderman talking about the whooping cough (pertussis) epidemic. My first thought as I listened to Dr. Snyderman was, “Why can’t autism ever be declared an epidemic?” While I am concerned that there are 1500 confirmed cases of whooping cough in my state (CA) and seven deaths from this disease is tragic; surely 1 in 100 children on the spectrum should justify the epidemic moniker. But sadly, despite the unprecedented and overwhelming number of children diagnosed with autism, it is still not recognized as an epidemic.
I felt more despair as I thought about the innocent babies that died from this disease. My heart goes out to these families. Their pain must be unimaginable. I wished life came with guarantees and that bad things never happened, but unfortunately, that’s not how life goes. I hate that seven deaths resulted from the 1500 cases of pertussis. I do. It’s awful.
But then I thought about how many children have been harmed by vaccination, including my older son. Immunization is not, nor has it ever been, a risk-free medical procedure. There’s no guarantee that that a child will be fully protected by a vaccine or that he/she will not experience a serious or deadly vaccine reaction. For parents, vaccine decisions are a careful balance of risk versus benefit.
With that depressing thought, I shifted my attention back to Dr. Snyderman who was really upset. She was (again) fired up about parents who were either not vaccinating or under-vaccinating their children thus allegedly causing California’s pertussis epidemic.
During the next two minutes, I heard several very misleading and over reaching statements from Dr. Snyderman. Watch it yourself HERE.
Here are the statements I took umbrage with:
“I think what we are seeing here is a tipping point in unvaccinated children because the hot pockets are in families where frankly parents have under-vaccinated or decided not to vaccinate their children.”
Over simplification is the word that first came to my mind. Dr. Snyderman did not provide a basis for this statement and could not know for certain that under-vaccinating or not vaccinating is the reason for this epidemic. Here are a couple of interesting quotes from two studies, one from the United States and the other from Great Britain that look at this issue more broadly and point out that pertussis is increasing even though people are getting vaccinated.
“Bordetella pertussis causes whooping cough, an endemic respiratory disease that is increasing in prevalence despite vaccination efforts.”
J Infect Dis. 2007 Oct 15;196(8):1228-36
“Whooping cough is presently one of the ten most common causes of death from infectious disease worldwide. Despite a high vaccine uptake, resurgences of this disease have been observed in several countries.“
Eur J Clin Microbiol Infect Dis. 2000 Feb;19(2):77-88.
In fact, the CDC backs up these findings with this statement on pertussis:
The reemergence of pertussis has been attributed to various factors, including increased awareness, improved diagnostics, decreased vaccination coverage, suboptimal vaccines, waning vaccine-induced immunity, and pathogen adaptation.
Dr. Snyderman didn’t provide any references for her opinion, but apparently the CDC or the articles mentioned above are not her sources. Instead, she inexplicably chose to attribute the entire epidemic on under and non-vaccinating parents. It is interesting that she never mentioned suboptimal vaccines, waning vaccine-induced immunity or pathogen adaption.
“In Marin County just north of San Francisco has more cases than anywhere else.”
This is true. Marin County experienced 195 confirmed cases of pertussis between January 1 and June 30, 2010. However, Dr. Snyderman neglected to report that Fresno County comes in a close second with 177 cases during the same period. According to the July 20th report in The California Watch, HERE Fresno County’s rate of personal belief vaccination exemption is much lower than Marin’s and yet they are only trailing by 18 cases. Since the CDC attributes the spread of pertussis to several factors that may be synergistic, and because vaccination rates alone cannot explain the disparity between pertussis prevalence in Marin and Fresno Counties, it’s difficult to understand the basis for Dr. Snyderman’s opinion that lower vaccination rates are responsible for this epidemic.
“I am an unabashed, unapologetic advocate for vaccinations. They are safe. They work.”
Sometimes I wish I were one of those black and white type people that Dr. Snyderman seems to be. That is a much easier world to live in. It seems that living in Dr. Snyderman’s world, if you vaccinate your child, you are a good parent. If you don’t vaccinate, you are a bad parent. Case closed.
But I don’t live there. I live in a world where there are shades of gray. Parents have to do a risk-benefit analysis when it comes to vaccination based on a child’s individual medical history and/or circumstances. I also believe that parents have a right to philosophical and religious vaccination exemptions due to firmly held beliefs.
Also, when I hear Dr. Snyderman state that vaccines are safe and work without acknowledging that some children have been harmed and even killed by vaccines, I know she is not telling the whole story. If vaccines were safe 100% of the time for 100% of the people, there would not be a Vaccine Injury Compensation Program where 2480 claims worth millions of dollars have been processed since 1988. HERE
Dr. Snyderman’s claim that vaccines work contradicts my personal experience. After my son was diagnosed with autism, we took him to see an immunologist. This doctor ordered several titer tests for the vaccines my son received as an infant. The results were astonishing. At the time of testing, he had received the full schedule of vaccines. The tests showed that only mumps and rubella had shown conclusive immunity. The rest of the vaccines failed to produce immunity for him. Vaccine titer tests are not routine. In reality, we actually have no idea how many children there are with no or low immunity to their vaccines. I wonder how many other children are like my son?
Brace yourself, the next statement calls into question our rights both as individuals and parents.
“There is a time when the community as a whole, their needs are better than the individual and I think more important. And right now the individuals are trumping the general populace at large. I find it frankly offensive and amoral.”
I am shocked and concerned by the implications of this statement. Dr. Snyderman is inferring there is an acceptable level of collateral damage in the war against infectious disease while inexplicably ignoring the science. Her personal opinion contradicts the CDC and the latest research while leaping to a judgment that parents enforcing their individual rights are compromising the community as a whole.
How did she come to that conclusion? Why isn’t Dr. Synderman calling for further research to improve “suboptimal vaccines,” overcome “pathogen adaptation” or explain how “improved diagnostics” may be at the heart of this “epidemic.” Without an answer to these important issues, more infants will likely be at risk for pertussis infections regardless increased vaccination in their communities.
Based on her statements, it appears that Dr. Synderman doesn’t value individual rights and is unaware of the latest research concerning pertussis as well as the CDC’s findings on the core reasons behind the resurgence of pertussis infections. So how has she determined the needs of the community? And how does Dr. Snyderman decide whose life is more important, the immuno-compromised person who cannot be vaccinated or the individual who dies from a vaccine reaction? How does Dr. Snyderman parse out which life is more valuable?
There have been 1035 death cases processed in the Vaccine Injury Compensation Program. Not all those claims have been compensated but many have. The sad and uncomfortable fact is that children and adults can and do die from a vaccine reaction but this is rarely mentioned. Their loss is not just individual, it hurts the community when a life is lost due to a vaccine injury.
I guess we are back to Dr. Snyderman’s black and white world. The world where she doesn’t recognize that people are sometimes harmed by vaccines or that vaccines don’t work all the time. That’s a safe world. I wish I lived there. I live in a world where I saw my son harmed by a vaccine. I live in the world where most of my friends (not all) in the autism community saw the same thing happen to their children.
In a nutshell, Dr. Snyderman feels that a person is amoral and offensive if they do not vaccinate for pertussis because it allegedly puts others at risk. However, the resurgence of the pertussis vaccine is much more complex than she is willing to admit. Whether it’s pertussis or many of the vaccines recommended for young children, fighting infectious diseases isn’t necessarily as simple as increasing vaccination rates. The sooner that Dr. Snyderman and other doctors actually studies the science, the closer we will get to safeguarding the health of infants, developing vaccines that are safer and more effective, as well as protecting the rights of both individuals and the community.
Parents like myself are asking the CDC to fight infectious disease more safely. However, that reasonable request falls on deaf ears, just like the request to proclaim autism an epidemic. It’s awful.
Since Dr. Snyderman is an extremely visible medical professional with a huge platform to disseminate her views, I hope that she will take the time to read the science and consider the CDC’s findings before she makes more misinformed claims on the root causes of prevalence of whooping cough and other infectious diseases in our communities. Many more people heard her view on the whooping cough epidemic than will ever read this essay. Dr. Snyderman has heard of thousands of parents reporting that their children regressed at the time of vaccination and refuses to listen, and now she refuses to acknowledge the science to further her personal opinion. Bottom line, THAT is amoral and offensive to me.
Becky Estepp is the mother to two boys. Her oldest son, Eric is a child with autism. Becky was an early member of Talk About Curing Autism (TACA) and assisted in the launch of the San Diego TACA Chapter in 2001. She has been leading the San Diego TACA Chapter since 2003 and worked for TACA for several years. Becky’s latest role is Government and Media Relations Manager for SafeMinds. She has worked with the press extensively on issues related to autism and vaccine safety. Becky has appeared in such media outlets as: Good Morning America, ABC's World News Tonight, Wall Street Journal, CNN, USA Today, The New England Journal of Medicine and NPR. Becky has a B.A. in Communications from California State University, Northridge. Before autism came into her life, she worked as a marketing manager for Kaplan Educational Centers. Becky lives in San Diego, California with her husband, Jack and their sons.